背景:未经治疗的精神病(DUP)的持续时间已被证明与精神分裂症的短期和长期结局不良相关。即便如此,很少有研究使用功能神经影像学来研究精神分裂症中的DUP。在本研究中,我们使用近红外光谱(NIRS)研究了DUP对精神分裂症患者言语流畅性测试(VFT)时脑功能的影响.
方法:共纳入62例精神分裂症患者。他们被分为短期治疗(≤6个月,n=33)或长期治疗(>6个月,n=29)组基于其治疗持续时间。使用多通道NIRS测量VFT期间额颞区的血液动力学变化。我们检查了每组DUP和血液动力学变化之间的关联,以探索DUP在不同治疗持续时间对大脑皮层活动的不同影响。
结果:在长期治疗组中,我们发现在较长的DUP和大约在左额下回的皮质活动减少之间存在显著关联,左额中回,左中央后回,右中前回,双侧颞上回,和双侧颞中回,而在短期治疗组中未观察到DUP与大脑皮层活动之间的关联。
结论:我们的研究结果表明,长期DUP时间延长可能与额颞区皮质活动水平降低有关。早期发现和干预缩短DUP的精神病可能有助于改善精神分裂症患者的长期预后。
BACKGROUND: Duration of untreated psychosis (DUP) has been shown to be associated with both poor short-term and long-term outcomes in schizophrenia. Even so, few studies have used functional neuroimaging to investigate DUP in schizophrenia. In the present study, we used near-infrared spectroscopy (NIRS) to investigate the influence of DUP on brain functions during a verbal fluency test (VFT) in patients with schizophrenia.
METHODS: A total of 62 patients with schizophrenia were included. They were categorized into either short treatment (≤6months, n=33) or long treatment (>6months, n=29) groups based on their duration of treatment. Hemodynamic changes over the frontotemporal regions during a VFT were measured using multi-channel NIRS. We examined the associations between DUP and hemodynamic changes in each group to explore if there were different effects of DUP on brain cortical activity at different treatment durations.
RESULTS: In the long treatment group, we found significant associations between a longer DUP and decreased cortical activity approximately at the left inferior frontal gyrus, left middle frontal gyrus, left postcentral gyrus, right precentral gyrus, bilateral superior temporal gyrus, and bilateral middle temporal gyrus, whereas no associations between DUP and brain cortical activity were observed in the short treatment group.
CONCLUSIONS: Our results indicated that longer DUP may be associated with decreased level of cortical activities over the frontotemporal regions in the long-term. Early detection and intervention of psychosis that shortens DUP might help to improve the long-term outcomes in patients with schizophrenia.